Definition

What is shaken baby syndrome?

Shaken baby syndrome — also known as abusive head trauma, shaken impact syndrome, inflicted head injury or whiplash shake syndrome — is a serious brain injury resulting from forcefully shaking an infant or toddler.

Shaken baby syndrome destroys a child’s brain cells and prevents his or her brain from getting enough oxygen. Shaken baby syndrome is a form of child abuse that can result in permanent brain damage or death.

Shaken baby syndrome is preventable. Help is available for parents who are at risk of harming a child. Parents also can educate other caregivers about the dangers of shaken baby syndrome.

How common is shaken baby syndrome?

Shaken baby syndrome is more common in children under age 2, but it can affect children up to age 5. Most cases of shaken baby syndrome occur among infants that are 6 to 8 weeks old, which is when babies tend to cry the most. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of shaken baby syndrome?

You may not see any signs of physical injury to the child’s outer body. Sometimes, the face is bruised. Injuries that might not be immediately seen include bleeding in the brain and eyes, spinal cord damage, and fractures of the ribs, skull, legs and other bones. Many children with shaken baby syndrome show signs and symptoms of prior child abuse.

In mild cases of shaken baby syndrome, a child may appear normal after being shaken, but over time he or she may develop health or behavioral problems.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

Seek immediate help if you suspect your child has been injured by violent shaking. Contact your child’s doctor or take your child to the nearest emergency room. Getting medical care right away may save your child’s life or prevent serious health problems.

Causes

What causes shaken baby syndrome?

Shaken baby syndrome occurs when someone violently shakes an infant or toddler. People may shake an infant out of frustration or anger, often because the child won’t stop crying. Although shaking does eventually make the baby stop crying, it’s usually because the shaking has damaged their brain.

Babies have weak neck muscles and often have difficulty supporting their heads. When an infant is forcefully shaken, their head moves uncontrollably. The violent movement repeatedly throws the baby’s brain against the inside of the skull, causing bruising, swelling, and bleeding.

Risk factors

What increases my risk for shaken baby syndrome?

There are many risk factors for shaken baby syndrome, such as:

Unrealistic expectations of babies

Young or single parenthood

Stress

Domestic violence

Alcohol or substance abuse

Unstable family situations

Depression

A history of mistreatment as a child

Also, men are more likely to cause shaken baby syndrome than are women.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How isshaken baby syndrome diagnosed?

To make a diagnosis, the doctor will look for the three conditions that often indicate shaken baby syndrome. These are:

Encephalopathy, or brain swelling

Subdural hemorrhage, or bleeding in the brain

Retinal hemorrhage, or bleeding in a part of the eye called the retina

The doctor will order a variety of tests to check for signs of brain damage and to help confirm the diagnosis. These tests may include:

MRI scan, which uses powerful magnets and radio waves to produce detailed images of the brain

CT scan, which creates clear, cross-sectional images of the brain

Skeletal X-ray, which reveals spine, rib, and skull fractures

Ophthalmic exam, which checks for eye injuries and bleeding in the eyes

Before confirming shaken baby syndrome, the doctor will order a blood test to rule out other potential causes. Some symptoms of shaken baby syndrome are similar to those of other conditions. These include bleeding disorders and certain genetic disorders, such as osteogenesis imperfecta. The blood test will determine whether or not another condition is causing your child’s symptoms.

How is shaken baby syndrome treated?

Some babies will stop breathing after being shaken. If this occurs, CPR can keep your baby breathing while you wait for medical personnel to arrive.

The American Red Cross recommends the following steps to perform CPR:

Carefully put the baby on their back. If you suspect a spinal injury, it’s best if two people gently move the baby so the head and neck don’t twist.

Set up your position. If your infant is under age 1, put two fingers on the middle of the breastbone. If your child is over age 1, place one hand on the middle of the breastbone. Put your other hand on the baby’s forehead to keep the head tilted back. For a suspected spinal injury, pull the jaw forward instead of tilting the head, and don’t let the mouth close.

Perform chest compressions. Press down on the breastbone and push about halfway into the chest. Give 30 chest compressions without pausing while counting out loud. The compressions should be firm and fast.

Give rescue breaths. Check for breathing after the compressions. If there’s no sign of breathing, tightly cover the baby’s mouth and nose with your mouth. Make sure the airway is open and give two breaths. Each breath should last about one second to make the chest rise.

Continue CPR. Continue the cycle of 30 compressions and two rescue breaths until help arrives. Be sure to keep checking for breathing.

In some cases, the baby may vomit after being shaken. To prevent choking, gently roll the baby onto their side. Make sure to roll their entire body at the same time. If there’s a spinal cord injury, this method of rolling reduces the risk of further damage to the spine. It’s important that you don’t pick up the baby or give the baby food or water.

There’s no medication to treat shaken baby syndrome. In severe cases, surgery may be required to treat bleeding in the brain. This may involve placement of a shunt, or thin tube, to relieve pressure or to drain excess blood and fluid. Eye surgery may also be needed to remove any blood before it permanently affects vision.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage shaken baby syndrome?

The following lifestyles and home remedies might help you prevent shaken baby syndrome:

New parent education classes can help parents better understand the dangers of violent shaking and may provide tips to soothe a crying baby and manage stress.

When your crying baby can’t be calmed, you may be tempted to try anything to get the tears to stop — but it’s important to always treat your child gently. Nothing justifies shaking a child.

If you’re having trouble managing your emotions or the stress of parenthood, seek help. Your child’s doctor may offer a referral to a counselor or other mental health provider.

If other people help take care of your child — whether a hired caregiver, sibling or grandparent — make sure they know the dangers of shaken baby syndrome.

If you have any questions, please consult with your doctor to better understand the best solution for you.